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- 00:00 – MISMARPE / DOME: what are they and why are they being combined for maxillary expansion?
- 01:07 – What is the surgical protocol for MISMARPE / DOME and how does it differ from conventional SARPE?
- 02:40 – What are the main advantages of MISMARPE compared with surgically assisted expansion (SARPE)?
- 03:17 – How does MISMARPE expansion compare with MARPE?
- 04:52 – What are the clinical indications
MISMARPE / DOME what is it?
Join me for a look at maxillary expansion combining both surgery with miniscrews. Seemingly opposite ideas have been brought together to offer potentially greater versatility in expansion, with less surgical complexity and complications.
MISMARPE – minimally invasive surgery miniscrew assisted rapid palatal expansion Haas 2021
Or
DOME Distraction Osteogenesis Maxillary Expansion Liu 2017
Protocol
· Osteotomy
o Anterior vertical incision interdental to periform fossa
o Lateral incisions to the base of zygomatic process of maxilla
o Without releasing the pterygomaxillary suture
o Activate in surgery up to 20x ensure diastema
o Duration 24 minutes (14.4-32) Junior 2021
o Less pain – Mild on VAS
· Expansion
o 7 days no expansion
o Expansion of rate 0.25 – 0.50 mm,
§ Some until diastema and slow to 0.25 per day
Advantages
· Less osteotomies required
· Under sedation or local anaesthetic
· Greater anchorage for force delivery through miniscrews
· Less intra-operative haemorrhage – due to a lack of pterygopalatine disjunction
· Parallel expansion – Lin 2015 Vs V shape expansion
Age
Limitation of MARPE was age, with 20-30 years females 94% 20-30 years males 80%, MARPE success 30-37 = 20% Olivera 2021, MISMARPE 96% success age 20-59, 24 patients majority over 30 years old Piccoli 2023.
Expansion amount
· Direct comparison show no significant difference da Silva 3mm, and no difference in molar angulation 2023
Indicated for:
· Failed MAPRE
· Age- greater 30 females and 25 for males
Could MISMARPE / DOME replace SARPE?
